Title

Parents of Children with Complex Trauma: Occupations Viewed Through Photovoice

Date of Paper/Work

12-2017

Type of Paper/Work

Doctoral Project

Degree Name

Doctor of Occupational Therapy

Department

Occupational Science/Occupational Therapy

First Advisor

Katherine Barrett

Abstract

This qualitative study represents a project idea that shifted focus during the three-year doctoral program. The original idea was to develop an intervention model in response to an identified need within a clinical setting. Specifically, within a clinic that specialized in services for people with sensory processing disorders, a trend was observed that suggested a more traditional sensory processing approach was no longer as effective as it had been in the past. Further investigation into potential factors revealed that the children who did not demonstrate expected improvements presented some common factors. Many of the children were adopted, some from orphanages and some from foster homes. Many, if not most children were identified with trauma histories. Jane Koomar, a well-known expert in sensory integration, and Dan Hughes, a renowned expert in the field of trauma and attachment disorders, developed a conceptual model incorporating sensory integration-based occupational therapy, mental health, and the family. My project in the Evidence Based Practice class addressed the evidence for this approach, in preparation for an anticipated feasibility study.

Clinic circumstances necessitated a change, however, and in the Occupation, Participation, and Justice class I interviewed one parent and conducted a focus group of three parents whose children had complex trauma. Parents described feelings of isolation and marginalization, they experienced diminished social circles, and services were difficult to find, even though their families had financial resources to access them. It was clear that the families were affected, not just the children, and in fact parents identified their wish for improved quality of family life. Further literature review suggested that these feelings and experiences were similar to those of parents with children who had mental health difficulties and disabilities in general. Missing from the literature, however, was a broad discussion of the occupations of parents whose children had complex trauma, from their own perspectives. This doctoral project therefore focused on the occupations of parents whose children had complex trauma.

While all the course work in the doctoral program helped provide building blocks for this doctoral project, three classes were especially helpful in this regard. The Educational Methods and Practices class furthered my interest in critical theory, extending into theories of learning, especially constructivism. Each person’s perspective is unique, informed by past experiences, and as such, study of parent occupations as individuals was compelling to me. The Evolution of Ideas class subsequently provided the framework for my study of occupation. Wilcock and Towsend’s (2014) conceptualization of occupation as doing, being, becoming, and belonging became the framework for this study.

Input from the first Occupation, Participation, and Justice class study, paired with the relatively sparse literature on the topic of occupations of parents whose children have complex trauma, suggested the need and benefit of further study in this area. Specific aims of the current doctoral study are to explore the occupations of this group of parents, and to provide an empowerment opportunity for the parents as they understand and advocate for desired changes in their lives. Results of this current study will hopefully contribute to knowledge and literature in the field of occupational science, and in turn will help inform occupational therapy practice and further research.

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